Join or Renew

The American Association for Long-Term Care Insurance is the professional trade association dedicated to serving the needs of insurance and financial services professionals, insurance companies and organizations as well as consumers throughout the United States and North America.

Use the online application form below or join by mail or fax with the printable membership application.

I am:

Applying for NEW Membership         RENEWING Membership

Personal Information

*Name
(Name for Member Certificate)
Title
Professional Designations
LTCP   CLTC   CSA   CLU   ChFC   LTCGS   Other
Company/Agency Name
*Mailing Address
*City
*State
*Zip Code
*Telephone
Fax
How did you hear about AALTCI?
Offer Code
*E-Mail
 (Used to provide member benefits and access to Members Only page)

Privacy Notice: AALTCI does not share any member personal information with any other company or entity. E-mails are provided solely for communication with members.


AALTCI'S FIND AN AGENT WEBSITE LISTING

Available only to licensed agents and brokers

By providing the information below, I give permission for the American Association for Long-Term Care Insurance to include my name, address and phone number on the AALTCI Find An Agent Directory. If provided below, we will list your E-mail address and Website. Further, I agree to uphold AALTCI's code of ethical standards. Note: The initial Website listing is free with individual paid membership. Subsequent changes requested cost $10.

E-Mail Address to list  
Website Address to list

PAYMENT

I wish to join / renew for ( Check ONE ):
1 year ( $49-)
2 years   ( $79-)
3 years ( $99-)

Pay By Credit Card (MC. Visa, Amex) I authorize AALTCI to charge the membership fee to my credit card.

*Card Number
*Exp Date
*3 or 4 Digit Security Code
*Name on Card  
*Credit Card Billing Address